Informed Consent to Treatment
Grievance Process

Informed Consent to Treatment

****This consent is not intended to be all inclusive. It is only intended to provide some useful information before deciding to engage in treatment. ****

Consent to Treatment: Each client will be given a clear description and recommendations from their provider or program supervisor regarding the problems, diagnosis, personal strengths/limitations, and treatment interventions proposed. Times, dates, and session length will be discussed by your provider or program supervisor. Clients have the right to participate in treatment decisions, seek a second opinion, as well as terminate services or refuse treatment at any time.

Assessment: The first session may include a comprehensive assessment of your needs and treatment planning. This is often a requirement of your insurance company and is necessary for treatment and payment.

Right to Terminate: You are voluntarily agreeing to treatment and may terminate at any time. Furthermore, your provider may make diagnostic and treatment recommendations with which you do not agree (e.g. modality of treatment, duration of treatment, frequency of visits, etc.). YOU have a right to discuss this and will have a part in treatment planning. You may also seek a second opinion for any services which you do not agree with. Please discuss termination with your provider so they can conclude services and help give any referrals that may be needed.

No Guarantee: Providers cannot guarantee results (e.g. less depressed, improved marital satisfaction, etc.). However, there will be clearly stated reasons, goals, and objectives for continuing/discontinuing treatment. This will be discussed with your individual provider.

Risks and Benefits: There may be some risks in participating in services. These may include discussing uncomfortable aspects of your life which may bring up unpleasant feelings. However, the benefits of the treatments often outweigh the risks; please discuss these concerns at any point with your provider. In the case of psychiatric care, medications, side effects, and alternative treatments will be discussed.

Emergency Services: In the case of an emergency, Ability Health and Rehabilitation, LLC maintains an available hour’s system. Discuss with your provider or program supervisor how to access this service. Emergencies are often life-threatening, and you should call 911 or go to the nearest emergency room if you are experiencing a life-threatening emergency.

Documentation: Each provider is required to keep documentation of treatment. This includes when, where and how long the appointments lasted, what interventions were utilized and your participation level.

Consent for Minors: State law mandates that each of a minor’s legal guardians must consent to treatment. Please ask the front desk or your provider for the appropriate form for all parties to sign. You can provide appropriate legal documentation regarding guardianship to the office staff or to your provider.

Communication: Generally, you will be contacted by phone or mail. Internet e-mail is discouraged unless discussed with your therapist. PLEASE NOTE: Privacy and Confidentiality cannot be guaranteed. Ability Health and Rehabilitation, LLC does NOT utilize encrypted email at this time.

Court Proceedings: The staff at Ability Health and Rehabilitation, LLC does not get involved in court proceedings. This includes writing letters and making court appearances. If subpoenaed, the client will be responsible for the cost of the staff member’s time and travel costs. These fees are not covered by insurance and are at a much higher rate than our usual fees. Particularly in the case of minor children we advise against subpoenaing your counselor to testify. This undermines the therapeutic relationship and is not conductive to healing. Please talk more with your therapist about this.

Ability Health and Rehabilitation, LLC here after AHR share responsibility for your care and your satisfaction with the services you receive. Our grievance procedures are designed to empower you and/or your representative to express any concerns or dissatisfaction you have so that we can address them in a timely and efficient manner. At any time, should you wish to file a grievance, we are available to assist you. If you do not speak English, a bilingual staff member or translation services will be available to assist you with the process.

You will not be discriminated against because a grievance has been filed. Ability Health and Rehabilitation will continue to provide you with all the required services during the grievance process. The confidentiality of your grievance will be maintained throughout the grievance process and information relating to your grievance will only be released to authorized individuals.

A grievance is defined as a complaint, either written or oral, expressing dissatisfaction with the services provided or the quality of participant care. A grievance may include, but is not limited to:

  • The quality of services.
  • Waiting times on the phone when you call the office.
  • Behavior of any of the care providers or program staff.
  • Transportation services; and
  • A violation of a participant’s rights.

A representative is the person who is acting on your behalf or assisting you, and may include, but is not limited to, a family member, a friend, or a person legally identified as Power of Attorney for Health Care/Advanced Directive, Conservator, Guardian, etc.

Grievance Process

Participant Grievances.
The information below describes the grievance process for you and/or your representative to follow should you and/or your representative wish to file a grievance.

  1. You can verbally discuss your grievance either in person or by telephone with the AHR Service Coordinator at (208) 333-9578. The staff person will make sure that you are provided with written information on the grievance process and that your grievance is documented on the Grievance Report form. You will need to provide complete information of your grievance so the appropriate staff person can help to resolve your grievance in a timely and efficient manner. If you wish to submit your grievance in writing, please send your written grievance to: Service Coordinator, Ability Health and Rehabilitation, LLC 10101 W. Overland Rd., Suite 110 Boise, ID 83709.
  2. The AHR Service Coordinator who receives your grievance will help you document your grievance (if your grievance is not already documented) and coordinate investigation and action. ALL information related to your grievance will be held in strict confidence and will not be disclosed to Caregiver or contract providers, except where appropriate to process the grievance. No reference that you have elected to file a grievance with Ability Health and Rehabilitation will appear in your medical record.
  3. You will be sent a written acknowledgement of receipt of your grievance within five (5) calendar days. Where necessary, the Service Coordinator will acknowledge your grievance by telephone and will clarify information provided on the Grievance Report Form or will obtain and document additional facts related to your grievance. Investigation of your grievance will begin immediately to find solutions and take appropriate action.

The AHR Service Coordinator will make every attempt to resolve your grievance within thirty (30) calendar days of receipt of your grievance. If you are not satisfied with that resolution, you and/or your representative have the right to pursue further action.

In the event resolution is not reached within thirty (30) calendar days, you and/or your representative will be notified in writing of the status and estimated completion date of the grievance resolution.

If you feel your grievance involves a serious or imminent threat to your health, including, but not limited to, potential loss of life, limb or major bodily function, severe pain, or violation of your participant rights, the AHR Service Coordinator will expedite the review process to a decision within 72 hours of receiving your verbal and/or written grievance and request for expedition.

Upon Ability Health and Rehabilitation completion of the investigation and reaching a final resolution of your grievance, you will receive written notification that will provide you with a report describing the reason for your grievance, a summary of actions taken to resolve your grievance, and options to pursue if you are not satisfied with the resolution of your grievance.

If you and/or your representative still not satisfied with the response by Ability Health and Rehabilitation, you and/or your representative has the right to call the Idaho Department of Health and welfare at 1 (877) 456-1233, or any outside representative of your choice without fear of retaliation.